Probable Bexarotene Hepatotoxicity Associated With Transient Serum Antimitochondrial Antibodies

Abstract

Bexarotene is a retinoid X receptor agonist approved for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma. In clinical trials, its use has been associated with elevations in serum aminotransferase activities. This report describes a case of probable bexarotene-induced hepatocellular injury in a woman, which was originally misdiagnosed as primary biliary cirrhosis because of the transient presence of serum antimitochondrial antibodies. Liver biopsy showed portal and periportal inflammation, ceroid-laden macrophages and normal bile ducts. Serum aminotransferase activities returned to normal approximately 8 weeks after discontinuing bexarotene and serum antimitochondrial antibodies were not detectable approximately one year after stopping the drug. This case reinforces the need to consider the possibility of drug-induced liver injury in patients taking bexarotene and that serum antimitochondrial antibodies may be transiently detectable in such individuals.